Individual
AMANDA KRANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
790 E 5TH ST, COQUILLE, OR 97423-1755
(541) 396-7295
Mailing address
790 E 5TH ST, COQUILLE, OR 97423-1755
(541) 396-7295
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201902517RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201908745NP-PP
OR
Other
Enumeration date
06/14/2019
Last updated
06/16/2020
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